COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Name of Person Filing Document: Address:City, State, Zip Code: Telephone Number: Attorney Bar Number (if applicable): RepresentingSelf orAttorney for. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SUPERIOR COURT OF ARIZONA MARICOPA COUNTYTHE PEOPLE OF THE STATE OF NEW YORK TOIn the Matter of the Conservatorship of:Case Number PB: PETITION FOR PERMANENT APPOINTMENT OF CONSERVATOR OF AN ADULT (Protected Person)GREETINGS:REQUIRED INFORMATION FROM PETITIONER, UNDER OATH: 1.WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableINFORMATION ABOUT ME. I am called the Petitioner: Name:,located at County ofSocial Security Number: Address:Telephone:o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomDate of Birth: My relationship to the person I say needs a conservator is:2.INFORMATION ABOUT THE PERSON I SAY NEEDS A CONSERVATOR. This person is called the proposed protected person (for a conservatorship): Name:Address:Telephone:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Date of Birth: Social Security Number:, one of the Justices of theCourt in Witness, Honorableday of, 20 County,3.PERSONS WHO ARE ENTITLED TO NOTICE of the court matter under Arizona law 14-5405 for conservators, and to whom I will give notice of this case: (See instructions)(Attorney must sign above and type name below)NameRelationship to Person Who I Say Needs a ConservatorAddressAttorney(s) forA. B.C. D.Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:© Superior Court of Arizona in Maricopa CountyPBCA11f Oct. 24, 2002Page 1 of 4Use only most current version ALL RIGHTS RESERVED APEMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)4.ASSETS OF PERSON WHOM I SAY NEEDS CONSERVATOR: (check one box) The person who needs a conservator has no substantial assets or income. No bond by Petitioner is required;The person who needs a conservator has assets and/or annual income in the approximate amount of $. Explain:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TO5.PERSON TO BE APPOINTED CONSERVATOR (complete this only if the person is a different person than Petitioner): Name:Address:Telephone:Social Security Number: Date of Birth:Driver's License Number: My relationship to the person I say needs a conservator:GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable6.INFORMATION REGARDING CONSERVATORSHIP. To the best of my knowledge, (check one box):,located at County ofNo Guardian and/or Conservator has been appointed in any other court, and no court proceedings are pending for such appointment; OR Someone has been appointed Guardian and/or Conservator, or court proceedings are pending. Explain who, when, in what court, and if the appointee is guardian or conservator:o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.7., one of the Justices of theCourt in Witness, Honorableday of, 20 County,REASONS FOR CONSERVATORSHIP: The person needs a Conservator because he or she has property which will be wasted or used up unless proper management is provided, and (check one or both boxes that apply): He or she needs funds for his or her support, care and welfare; Funds are needed for the support, care and welfare of those entitled to be supported by the person. 8.REASONS PERSON CANNOT MANAGE HIS or HER PROPERTY: (check all that you believe apply):(Attorney must sign above and type name below)Mental illness, mental deficiency, or mental disorderPhysical illness or disabilityChronic use of drugsChronic intoxicationAttorney(s) forConfinementDetention by a foreign power; Disappearance.9.APPOINTMENT OF AN ATTORNEY (You cannot ask the court for conservatorship unless the adult has a lawyer appointed to represent him or her. See the instructions on how to do this.) (Check one box only and fill in the information requested):Office and P.O. AddressThe person I say is a protected person already has an attorney who will represent the person in court about this conservatorship:Telephone No.: Facsimile No.: E-Mail Address:© Superior Court of Arizona in Maricopa CountyPBCA11f Oct. 24, 2002Page 2 of 4Use only most current version ALL RIGHTS RESERVED APEMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)NAME OF ATTORNEY: ADDRESS:TELEPHONE:OR,The protected person has no attorney to represent him or her in court, and I will contact the Office of Court-Appointed Counsel after I file this paperwork so that a lawyer can be appointed by the court.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.INFORMATION FOR APPOINTMENT OF A PHYSICIAN: I have the name, address, and telephone number of a physician who will examine the person I say needs protection and whose written report I will file with the court.THE PEOPLE OF THE STATE OF NEW YORK TOYes orNo.REQUIRED STATEMENTS TO THE COURT, UNDER OATH:(Note: you must check each box as true, and all these statements must be true, or you cannot file this Petitio
|
Get this form for FREE as a print-only pdf
